Provider Demographics
NPI:1780730119
Name:PASSON, JULIE ANN (FNP CNM)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:ANN
Last Name:PASSON
Suffix:
Gender:F
Credentials:FNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2051 KAEN RD STE 367
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-742-5300
Mailing Address - Fax:503-742-5932
Practice Address - Street 1:19761 BEAVERCREEK RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-9557
Practice Address - Country:US
Practice Address - Phone:503-785-8770
Practice Address - Fax:503-607-0112
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR091007399N1176B00000X
OR091007399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR090573Medicaid